The stem cell technology has a broad prospect for human health,but it would also give rise to ethical issues which cannot be ignored.To deal with these issues,we ought to adopt new approaches.The traditional vertical government approaches ought to be replaced with horizontal governance.Based on the new governance approaches,this paper proposes four suggestions for relieving the ethical impacts imposed by stem cell technology.These suggestions will be helpful for developing healthy stem cell technology.

BACKGROUND:It has become a hotspot to prepare the bone repair material that exhibits natural bone structure and is used in combination with biological factors. OBJECTIVE:To prepare the recombinant human bone morphogenetic protein-2 (rhBMP-2)/bone repair material, and to evaluate its capacities of release, activity and ectopic osteoinduction. METHODS:A collagen-binding domain was added to the N-terminal of native rhBMP-2 that allowed bind to collagens in the bone repair material. Then, rhBMP-2/bone repair material was obtained through freeze-dried method. The releasing ability of rhBMP-2 in vitro was assayed by ELISA. C2C12 cell lines were loaded to the composite material with 0.25, 0.5 and 1 μg rhBMP-2, respectively. Afterwards, alkaline phosphatase activity was detected at 72 hours. The composite materials with 0, 2, 5 and 10 μg rhBMP-2 were implanted into the quadriceps of Sprague-Dawley rats, respectively. Alkaline phosphatase activity and the newly formed bone were detected at 2 and 4 weeks after implantation. The CY-7-labeled composite material was implanted into the quadriceps of Sprague-Dawley rats to observe its stability. RESULTS AND CONCLUSION:Substantial y no rhBMP-2 from the rhBMP-2/bone repair material was released within 45 days. The alkaline phosphatase activity of C2C12 was in a rise with the increased concentration of rhBMP-2. The stability of the composite material in vivo was better, the alkaline phosphatase activity and ectopic bone formation increased as the concentration of rhBMP-2 rose. To conclude, the rhBMP-2/bone repair material preserves the stability of rhBMP-2, and improves ectopic osteoinduction ability.

Objective To assess the equity of health resources configuration in Zhejiang,and provide references for regional health planning.Methods The Lorenz curve,Gini coefficient and Theil index were used to calculate and analyze.Results The Gini coefficient in 2009-2011 calculated by population density was between 0.330～0.343,which meant comparatively rational.The main reason of inequity configuration for hospital beds and nurses was inter-regional difference.Conclusion The Theil index could remedy the disadvantage that Gini coefficient could not reflex the total inequity was brought up by inter-regional or intra-regional difference.The health resource configuration should based on population health need and health service demand.

Objective To evaluate the research input-output efficiency of 15 medical universities,and provide references for improving synthetic research efficiency.Methods Selected research input-output key indicators,and used CCR model and SE-DEA model to statistic and analyze.Results The average value of comprehensive efficiency of 15 medical universities was 0.811,pure technical efficiency value was 0.978,scale efficiency value was 0.827.There were 5 DEA efficient universities,7 pure technical efficient universities among 10 Non-DEA efficient universities.Conclusion The total research efficiency of medical universities in our country remained to improve,and should emphasize adjusting scientific research scale.

Scientificly forecasting the health resources is the premise and foundation for making health resource planning.This paper summarized the application scope and characteristics of commonly used statistical models for health resources forecasting,introduced many S type curve prediction models commonly used in natural and social economic fields,hackled and concluded the weight calculation methods of combination forecasting models,and on this basis put forward that multivariable time series model or combination forecasting model based on single time series model and multi-linear regression equation of the predictive value should be set up for forecasting health resources,so as to provide methodological references for related forecasting research.

Objective: To investigate the efficacy and safety of oxycodone hydrochloride prolonged-release tablets and tramadol hydrochloride sustained-release tablets in the treatment of moderate cancer pain. Methods:Totally 290 cases of the patients with mod-erate pain were divided into the observation group with 148 cases and the control group with 142 cases. The observation group received oxycodone hydrochloride prolonged-release tablets, while the control group was given tramadol hydrochloride sustained-release tablets. The treatment course was 2 weeks, and the total efficiency and the incidence of adverse drug reactions( ADR) in the two groups were calculated and compared. Results:The total efficiency in the observation group and the control group was 92. 6% and 81. 7%, respec-tively, and the difference was statistically significant (P<0. 01). The incidence of ADR was 60. 1% and 57%, respectively with no significant difference (P>0.05). Conclusion: The effect of oxycodone hydrochloride prolonged-release tablets in the treatment of moderate cancer pain is better than that of tramadol hydrochloride sustained-release tablets.

Objective To explore the antitumor mechanism of xianhe yanling recipe( XHYLR ). Methods The mechanism of action of 241 compounds contained in the Chinese medicine, XHYLR was studied by using computational pharmacological. Methods including molecular docking,biotechnology network,chemical space technology and the prediction of absorption,distribution,metabolism,excretion and toxicity( ADME/T). Results Most of the compounds in XHYLR had good drug-like properties. Distribution of 241 compounds in chemical space also revealed that these compounds showed similar anti-tumor activity. It suggested that the prescription of XHYLR was reasonable. The phenomena that one molecular interacted with multiple target proteins and several molecules interact with one target protein were observed in XHYLR. For example,the COX-2 interacted with 40 micromolecules,and catechin interacted with five targets including COX-2. Conclusion These results are helpful for understanding the complicated mechanism of anti-tumor activity of XHYLR.

Background:Inflammation plays an important role in intestinal ischemia-reperfusion injury(IRI),and erythropoietin (EPO)has been reported to have anti-inflammatory activity. Aims:To explore the protective effect of EPO on intestinal IRI and its potential mechanism. Methods:Thirty-two healthy male Sprague-Dawley rats were randomly divided into four groups:sham operation group(sham group),IRI group,EPO group and 740Y-P group. Rats in IRI,EPO and 740Y-P groups were injected intraperitoneally with 0. 9% NaCl,EPO and EPO + 740Y-P,respectively,one hour before the establishment of intestinal IRI model by superior mesenteric artery clamping(45 min)-reperfusion. All rats were sacrificed one hour after reperfusion. Histopathological changes of small intestine were observed;expression of proteins in PI3K/ Akt and NF-κB signaling pathways was measured by Western blotting;expression and secretion of inflammatory cytokines, including interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and monocyte chemoattractant protein-1(MCP-1)were examined by real-time PCR and ELISA. Results:Compared with sham group,the damage score of small intestine,protein expressions of PI3K,p-Akt and p-NF-κB p65,as well as mRNA expressions and serum levels of IL-8,TNF-α and MCP-1 in IRI group were significantly increased(P < 0. 05). EPO pretreatment could ameliorate the histopathological changes of small intestine in IRI model rats,inhibit PI3K/ Akt and NF-κB signaling activation and down-regulate expression and secretion of inflammatory cytokines. When 740Y-P,a PI3K agonist,was used combinedly,the effect exerted by EPO was diminished. Conclusions:EPO pretreatment can protect against intestinal IRI by inhibiting the activation of PI3K/ Akt/NF-κB signaling and the subsequent inflammatory response.

Objective:To explore the application of scenario simulation and rapid film reading training in the standardization of cervical vertebra DR examination in radiology department.Methods:Using the method of scene simulation in the examination room to take DR films of cervical vertebra, two senior technicians in charge evaluated and guided the deficiencies of junior technicians from the aspects of patient check, exposure conditions, body position placement, film printing, inspection safety and radiation protection. Every morning, DR images of cervical vertebra were randomly selected and read quickly, and the junior technicians should quickly browse the images within one minute and make quality control evaluation. Then the senior technician in charge pointed out the shortcomings of the evaluation and related improvement methods. After that, the technical specification manual of cervical vertebra DR was compiled based on the deficiencies and problems found by each technician, and 200 patients aged 18-55 years, without abnormal movement and no internal fixation before and after the establishment of standardization were randomly selected in group A (before standardization) and group B (after standardization). The image quality and repetition projection rate of group A and group B before and after the standardization were compared. SPSS 25.0 was used to analyze the data.Results:The image quality score of group B (8.83±0.33) was higher than that of group A (8.45±0.30), and the repetition projection rate of group B (2%) was lower than that of group A (9%), with statistical significance ( P<0.05). Conclusion:Through the training mode of rapid film reading and scenario simulation, the standardization of cervical vertebra DR examination technology suitable for the situation of the department has been established, which effectively solves the problem of abstraction in the technical teaching of radiology department. The standardization establishment plays an important role in standardized training, for which, the technicians can quickly grasp the work process of the department and the corresponding examination technology during participating in the standardization establishment and training process.

Objective To explore the efficacy of proximal femur locking plate(PFLP) for the treatment of unstable femoral intertrochanteric fractures in elderly patients.Methods Data of 120 cases of patients with unstable femoral intertrochanteric fractures who were treated by PFLP were retrospectively analyzed.There were 56 males and 64 were females,aging from 62 to 78 year-old (average,69.4 year-old).85 cases were left hip,and 35 cases right hip.According to AO fracture classification,there were 12 cases of A2.2,23 A2.3,34 A3.1,29 A3.2,and 22 A3.3.According to Evans intertrochanteric fractures classification:there were 93 cases of type Ⅲ,19 type Ⅳ,and 8 type Ⅴ.Operation time,length of hospital stay,fracture healing time,postoperative complications and hip joint Harris scores were recorded.Results All patients were followed up for 8-14 months (average,12.4 months).Their operating time were 51-80 min (average,63.1 min);X-ray exposure were 8-15 times (average,11.6 times);intraoperative blood loss were 70-120 ml (average,92.7 ml);postoperative drainage volume were 50-100 ml (average,61.7 ml),and length of hospital stay were 7-14 d (average,10.2 days).The healing time ranged from 12 to 32 weeks (20.4 weeks average).14 cases had delayed union,and healing time was 8-10 months.In addition,4 cases had deep vein thrombosis (after thrombolysis therapy the vein was recanalized);2 had internal fixation broken,who were then treated with PFNA Ⅱ,and bone healed after 6 months;5 had hip varus,who were then treated via hip replacement,and no hip prosthesis fracture were found.No other complications occurred in the remaining patients.At the latest follow-up,according to Harris hip score:there were 38 cases with excellent results,71 good,9 fair,and 2 poor,and the rate of excellent and good was 90.8％ (109/120).Conclusion PFLP for the treatment of unstable femoral intertrochanteric fractures has advantages of less invasion,less complication,reliable fixation and high fracture healing rate,thus it is suitable for unstable intertrochanteric fractures in elderly patients.